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He Can’t Orgasm … Is Diabetes to Blame?

I just stumbled across your wonderful site totally by accident and am really hoping you will be able to help me with a problem which is keeping me awake at night. I’ve been sexually active since I was 16. Since then, all of my male sexual partners have ejaculated during sex, but my current boyfriend is having a problem. This is affecting our sex life as I feel I must be doing something wrong. He has tried to reassure me he often hasn't been able to orgasm in the past with other partners and that he enjoys sex with me nonetheless - that he doesn’t have to come to be satisfied. But I don't fully enjoy myself knowing that he won't reach orgasm; it doesn't seem fair.
I know you recently answered a question in the same vein but I think my query is different as he is diabetic. I have recently heard that diabetes can affect sex and am wondering if this is true. He doesn't seem aware of the connection and I don't want to mention it without getting the facts first. Please help me, I love him dearly and in all other aspects our relationship is fantastic...but it doesn't fell right for me to be getting all the sexual pleasure.

Stephanie replies:

You know people really are all very different, and usually when we try to compare one partner with those of our past we miss the mark by a long shot because of those differences. So lets break your question down into a few different parts and take things one at a time.

Let’s take the big question off the table first – what connections have been made between diabetes and sex? One of the first facts about diabetes that is important to remember is that it’s what’s classed as chronic. Another words, it’s long term and can worsen over time. Sometimes chronic illness can lead to a lot of stress and anxiety, and for many people depression. All of these different reactions can mean just not being interested in sex at any one time, or some trouble in the process of sex itself. Consider that it’s pretty hard to find pleasure if we’re distracted or just not all that into sex at the moment. But these are things everyone may experience at times, so it’s not just a person with diabetes or a chronic illness that experiences them.

As for the physical side of sexual response and some of the things that are known about how diabetes can affect the body – there are a few things women or a man with diabetes may notice occurring during sex. First, for both men and women, is decreased or no desire to have any type of sex. This isn’t just linked to diabetes though, most people notice changes in how often or when they have sex, and it’s not uncommon for people to sometimes just not be very interested in sex at a certain time in their life – and there’s nothing wrong with that.

That said, both men and women can experience problems with sex as a result of damaged blood vessels and nerves. Consider this: how the body responds to sexual stimuli is involuntary (or an autonomic nerve reaction where the nerves send a message to the brain to cause physical responses.). These nerve signals increase the amount of blood that is flowing to the genitals. So damage to the nerves or the blood vessels can be a cause for some sexual problems.

As well, in women, a couple of other things that are often reported happening is a decrease in vaginal lubrication and painful or uncomfortable intercourse. There are two common physical problems for men with diabetes as well. The first of these is erectile dysfunction. It’s pretty normal for a man to have trouble either getting or keeping an erection from time to time, especially considering that partnered sex especially means a lot of emotions and at times a lot of stress. Using the term erectile dysfunction means that it’s continually a problem of either not being able to get an erection, or not being able to sustain one.

The second problem is what’s called retrograde ejaculation. Throughout the body there are internal muscles called sphincters, these close off a passage to one part of the body while another body function is taking place. Everything that comes out of the penis moves through a long tube called the urethra, and typically when a man ejaculates these sphincter muscles close off the path to the bladder, forcing semen to travel down to the tip of the penis and leave the body.

For some men that have diabetes, however, poor blood glucose control can cause nerve damage, and the sphincter muscles may not close off the path to the bladder. With this, the man may notice a little bit of ejaculate or none at all. The semen would then leave the body when he urinates, and it doesn’t hurt the bladder either. Sometimes men don’t even realize this is occurring unless there’s fertility problems later.

As with anything, it’s really important that your boyfriend is open with his doctor. If there is a chance that what he’s experiencing is related to his diabetes, his doctor will not only be able to refer him to a specialist, but also needs to watch for any other signs of a problem and keep record for his personal file.

I know that’s a lot of information already, but I think it’s also important that we address some of the other factors in your question. One of the big points I want to make is where you say that you feel that you must be doing something wrong. This is actually something we hear a lot – and usually when a partner is unable to reach orgasm or in men when they are unable to orgasm or ejaculate. In partnered sex, when both partners are consenting, boundaries are being respected, and the goal is pleasure, there really is no right or wrong way. Every person is different, so what two partners find works for them will not be exactly the same as two other people.

Any type of sex is really not something that you can consider on a small scale, as in thinking about it like a block rather than a building. I say this because sex isn’t just a there and gone thing, it’s really a process. When you think of it as a process, encompassing all of the parts of sex and all of the phases of arousal, then you can really begin to think about pleasure rather than an and result of orgasm and/or ejaculation. And really, orgasm can be great – but remember that in total orgasm only lasts for a few seconds.

Any type of sex is about pleasure, and sex should be pleasurable with or without orgasm. Think of it this way – someone buys you a really nice necklace; it’s beautiful and makes you really happy when you wear it. Sure, having a matching pair of earrings is an added bonus, but even without the earrings you have the necklace, and that’s important and special in its own.

If you start really looking into information about people not being able to orgasm from sex, you’ll likely run across the term “spectatoring.” This is known to be a real problem for orgasm with many people. Basically it’s where you place so much emphasis on orgasm, making it the Big Goal, and this distracts your mind and body from just being able to go with the natural flow of sex. If your partner is feeling like you’re not able to enjoy sex with him because of a lack of orgasm, it’s likely to affect him just as it is you – and the end result can very well be having trouble staying aroused enough and indeed becoming more aroused to the point that he can reach orgasm.

You’re not really defining what you mean by sex here – if you asking in your question about all different types of sex or if you are only referring to intercourse – so I want to make a point on that as well. There are some types of sex that for some people are just really unlikely to give the type of stimulation needed for them to reach orgasm. It’s no secret that a majority of women don’t orgasm from vaginal intercourse alone, and it’s understood that every person being different would mean what one person enjoys may be different than another, just as what will likely result in orgasm for one person may not be what get another person there. If you haven’t tried other types of sex or stimulation, you may start there and see if you notice a difference.

Another point I think needs to be brought up is that communication needs to play an important role in relationships, especially sexual relationships. Yes, I see that you have discussed this with him, but communication is more than just talking – it’s about listening as well. Mind, I’m not saying you haven’t heard the words that he’s said to you, but it doesn’t seem that you’re yet ready and able to take those at face value.

For instance, you say that it doesn’t feel right for you to be getting all of the sexual pleasure, but he’s told you that he *does* enjoy sex and that he *is* satisfied when he has sex with you. That right there is him telling you that by no means are you the only one receiving pleasure when the two of you have sex. I don’t see any reason why you wouldn’t be able to trust him when he tells you this.

With communication too, you can ask him to be open with you about the things that he enjoys the most, then if you’re comfortable with what he finds most enjoyable, you can make that more a part of sex together. Then you don’t have to worry that he’s not finding pleasure. As well, even asking him for some reassurance when you are having sex can help you to know to continue doing something or possibly change to something else. Bt the trust of what he’s telling you needs to be there first.

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